Social Problems and Solutions

—————————————————–
1. Articulate the types of benefit eligibility rules and provide a brief explanation of each.
2. What is the difference between the eligibility rule known as administrative discretion and the one known as administrative rule?
3. What is the major difference between professional discretion and administrative discretion as methods of determining eligibility for social welfare benefits or services?

4. Discuss how weak eligibility rules may invite political interference in the benefit administration process.

———————————————————-
Readings: Text, Chapter 6
Introduction
Air and water were once thought of as free goods. But today, no social welfare benefit is a ?free? good and because of this. We must have rules and regulations to allocate benefits to ensure that benefits get to the right audience.
Social workers and other human service practitioners need to understand eligibility rules because they work daily within the context of these guidelines and use them at all levels of complexity. As an agency representative, the practitioner needs to understand the details of eligibility rules so the applicant has the same chance to receive a benefit as every other qualifying citizen.
Practitioners also must face the reality that they are in the business of denying as well as qualifying clients/consumers for benefits. This is a hard fact of life that is a consequence of scarce resources and hard budget times.

Learning Objectives
? To articulate the types of eligibility rules
? To articulate criteria for evaluating the merit of eligibility rules
? To identify opportunites for political interference because of weak eligibility rules
? To articulate special problems that may arise in administering eligibility rules.

Lecture Notes

Types of Eligibility Rules
The decentralized disarray of the U.S. welfare system creates literally hundreds of public and private programs that offer welfare services and benefits. Each has a different set of rules for determining who gets what, how much, and under which conditions. We will group eligibility rules together so that we can discuss them without lengthy discussions.
Types of eligibility rules:
? Prior contributions
? Administrative rule
? Private contracts
? Professional discretion
? Administrative discretion
? Judicial decision
? Means testing (needs minus assets and/or income)
? Attachment to the workforce
Eligibility Rules Based on Prior Contributions
Eligibility for many important social welfare benefits is established by rules about how much prior contributions have been made to the system that will pay the benefit later. A prominent example is benefits paid by the U.S. Social Security System. Social Security includes retirement income for workers and survivors (OASI), disability income for workers and dependents (SSDI), and payments for medical care services (Medicare) for both the disabled and the retired.

Exactly how much prior contribution is required varies with the age at which benefit is drawn and the type of benefit in question, but some prior contribution is always required.
Unemployment Insurance (UI) represents another program in which eligibility rules are based on prior contributions.

Eligibility Rules Based on Administrative Rule and Regulation
Although eligibility rules for public social programs may be laid out in some detail in the law, seldom are they sufficiently detailed so that no administrative interpretations need to be made. Thus, we will call these administrative rules made to clarify the law. This is an advantage to client/beneficiaries because it gives social workers and other human service staff members a means by which to administer the benefit or service program even-handedly and reliably, so that people similarly situated are given similar benefits.
There are some eligibility rules that are almost fully spelled out in the law, and the food stamp program is probably the best example. All the details necessary to administer the program are spelled out in the law. This makes it easy on the program staff because no discretion is needed for the program staff to administer the benefit.
On the other hand, the rules for Temporary Assistance for Needy Families (TANF) are so numerous and concern so many different topics that they are bound into huge manuals. The administrative rules include state and federal rules and how for the program staff to interpret them.

Eligibility Rules Based on Private Contract
It is possible to become entitled to a public health benefit through the provisions of private contract. An example of this is workers? compensation system.

Eligibility Rules Based on Professional Discretion
Discretion is the power of a judge, public official or a private party (under authority given by contract, trust or will) to make decisions on various matters based on his/her opinion within general legal guidelines. The Oxford Dictionary defines discretion as ?the freedom to decide what should be done in a particular situation.? One of the most widely used sources of entitlement is the professional discretion of individual practitioners (doctors, mental health professionals, etc.). A common example is eligibility for medical benefits, which is almost always contingent on the discretion of the physician (or physician surrogate).

Eligibility Rules Based on Administrative Discretion
West’s Encyclopedia of American Law defines ?administrative discretion? as the exercise of professional expertise and judgment, as opposed to strict adherence to regulations or statutes, in making a decision or performing official acts or duties.
A discretionary action is informal and, therefore, unprotected by the safeguards inherent in formal procedure. A public official, for example, has administrative discretion when he or she has the freedom to make a choice among potential courses of action. ?Abuse of discretion? is the failure to exercise reasonable judgment or discretion. It might provide a ?cause of action? for an unconstitutional invasion of rights protected by the Due Process Clause of the Constitution.
A common example of this is the policy in some states and counties that allows a county welfare worker to distribute small amounts of cash and credits for food, housing, and utilities to poor people who apply. This kind of policy is characteristic of the General Assistance programs, financed by the local government and usually oriented toward short-term emergency budgets. The staff member must account for the funds only in the final sense. Administrative judgment is seldom called to account.

Eligibility Rules Based on Judicial Decision
Judicial decisions are important sources of eligibility, virtually ruling applicants in or out of program benefits and services. After a program has been in operation over a period of time , it is very likely that a contention will arise about whether the enabling legislation is working or whether an administrative rule or discretionary judgement has been managed consistent with the original spirit or intention of the law which established the program. These decisions serve as precedent and, occasionally, will adjust the way a program has been administered.
Eligibility by Means Testing
One of the best-known and most widely used of all eligibility rules is a means test: Income and assets are totaled to see whether they are less than some standard for what a person is believed to need. If the assets or income exceed this standard then no benefit is given. The central idea is that when assets and income are up to the standard, the person ?ought? to have enough to meet his or her needs.
Criteria Specific to Eligibility Rules ? Special Problems
??the ultimate test of the merits of any particular eligibility rule is its fit with the social problem under consideration.?
-Chambers and Wedel
Even though this is the ultimate test, special problems are likely to be created by eligibility rules. The analyst should continue to examine available data and the general workings of the program and be on the lookout for evidence of the following special problems:
Stigma and alienation ? Side effects of some eligibility rules may have some serious consequences that they outweigh benefits received.
To be stigmatized means to be marked as having lesser value, to bear the burden of public disapproval. Alienation means the sense of being estranged from the mainstream of the society within which one dwells.
Both alienation and stigmatization are serious side effects that are believed to be associated with many consequences, such as suicide, social deviance, tendency toward serious crime, and chemical addiction.
Off-targeting of benefits ? The extent to which benefits are directed to population groups who are not the main object of the program. Are the benefits missing the target population?
Overwhelming costs ? Bad eligibility rules can create severe overutilization and, thus, serious cost overruns. Overutilization and underutilization can be the result of bad eligibility rules that cause the benefits or services either do not reach the intended audience, too much reaching the intended target or too much reached the wrong target.
Political interference ? Political influence can be useful to get a program started but damaging once the program is in motion. Once the program is implemented, it becomes bad social policy for citizens, or groups of them, to be either eligible or not simply because of political influence that circumvents the legislation or judicial process that keeps social policy as an expression of the will of the people.
Negative incentives and disincentives ? Eligibility rules should be evaluated against their potential for work disincentives. There is always the argument about whether social welfare income maintenance programs cause people to choose benefits over work for wages . This argument is several hundred years old. A related problem is how to transition people having disabilities and receiving wage maintenance benefits back into the workforce. The authors provide discussion on this topic on pages 129-133.
Summary
In this chapter, types of eligibility rules are discussed. Special problems with eligibility rules are discussed. The concept of political interference because of weak eligibility rules was discussed. It is important to remember that the presence of any of the special problems discussed works against the achievement of a functional policy and its programs ? against adequacy, equity, and efficiency. This is a short summary but powerful and worth remembering.
Discussion Board
Write one to two brief but comprehensive paragraphs on each of the following:
1. Articulate the types of benefit eligibility rules and provide a brief explanation of each.
2. What is the difference between the eligibility rule known as administrative discretion and the one known as administrative rule?
3. What is the major difference between professional discretion and administrative discretion as methods of determining eligibility for social welfare benefits or services?
4. Discuss how weak eligibility rules may invite political interference in the benefit administration process.

Read the textbook assignments first, and then read the online lecture before going to the Discussion Board to post your comments. For best results, have the textbook with you when you read the online lecture.
Post all Discussion Board comments as text?not in an attachment. Remember that this is your class discussion time for this course. Your comments need to be presented to all classmates at the same time and in the most direct manner possible. If you prepare Discussion postings at more than one setting, store them in a Word document that can easily be cut and pasted on the Discussion Board.
Post your responses early enough in the week to allow time to participate in the discussion as others post their comments and you respond to each other. Add or respond to what others say and disagree with them respectfully when you have differing views. A lively discussion is always welcome, and your participation determines a significant part of your grade in the course.